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GAO-11-259R 1 (2010-12-15)

handle is hein.gao/gaobadxdl0001 and id is 1 raw text is: 

   I
   GA0
LV.WX11M§= Accountability * Integrity * Reliability
United States Government Accountability Office
Washington, DC 20548


          B-321287


          December 15, 2010

          The Honorable Max Baucus
          Chairman
          The Honorable Charles E. Grassley
          Ranking Member
          Committee on Finance
          United States Senate

          The Honorable Henry A. Waxman
          Chairman
          The Honorable Joe L. Barton
          Ranking Member
          Committee on Energy and Commerce
          House of Representatives

          Subject: Department of Health and Human Services: Health Insurance Issuers
                  Implementing Medical Loss Ratio (MLR) Requirements Under the Patient
                  Protection and Affordable Care Act

          Pursuant to section 801(a)(2)(A) of title 5, United States Code, this is our report on a
          major rule promulgated by the Department of Health and Human Services (HHS),
          entitled Health Insurance Issuers Implementing Medical Loss Ratio (MLR)
          Requirements Under the Patient Protection and Affordable Care Act (RIN: 0950-
          AA06). We received the rule on November 22, 2010. It was published in the Federal
          Registeras an interim final rule with request for comments on December 1, 2010. 75
          Fed. Reg. 74,864.

          The interim final rule implements the medical loss ratio (MLR) requirements for
          health insurance issuers under the Public Health Service Act (PHS Act), as added by
          the Patient Protection and Affordable Care Act (Affordable Care Act). This interim
          final regulation adopts and certifies in full all of the recommendations in the model
          regulation of the National Association of Insurance Commissioners (NAIC) regarding
          MLRs. It is being published to implement section 2718(a) through (c) of the PHS Act,
          relating to bringing down the cost of health care coverage through a new MLR
          standard. Subpart A implements the requirements for reporting the data to be
          considered in determining that ratio. Subpart B addresses the requirements for
          health insurance issuers (issuers) in the group or individual market, including
          grandfathered health plans, to provide an annual rebate to enrollees, if the issuer's


GAO-11-259R

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